PURPOSE: Transplantation of hematopoietic stem cells from an unrelated donor (URD) is an option for many patients who do not have an HLA-identical sibling donor (MSD). Current criteria for the selection of URDs include consideration for HLA alleles determined by high resolution typing methods, with preference for allele-matched donors. However, the utility and outcome associated with transplants from URDs compared with those from MSDs remains undefined. PATIENTS AND METHODS: We examined clinical outcome after patients received bone marrow transplants (BMTs) from MSDs; HLA-A, -B, -C, and DRB1 allele-matched URDs (8/8); and HLA-mismatched URDs in a homogeneous population of patients with chronic myeloid leukemia (CML) in first chronic phase (CP1) where a strong allogeneic effect and hence a lower risk of relapse is anticipated. Transplantation outcomes were compared between 1,052 URD and 3,514 MSD BMT recipients with CML in CP1. RESULTS: Five-year overall survival and leukemia-free survival (LFS) after receipt of BMTs from 8/8 matched URDs were worse than those after receipt of BMTs from MSDs (5-year survival, 55% v 63%; RR, 1.35; 95% CI, 1.17 to 1.56; P < .001; LFS, 50% v 55%; RR, 1.21; 95% CI, 1.06 to 1.40; P = .006). Survival was progressively worse with greater degrees of mismatch. Similar and low risk of relapse were observed after receipt of transplant from either MSD or URD. CONCLUSION: In this homogeneous cohort of good risk patients with CML in CP1, 5-year overall survival and LFS after receipt of transplant from 8/8 allele-matched donors were modestly though significantly worse than those after receipt of transplant from MSDs. Additive adverse effects of multilocus mismatching are not well tolerated and should be avoided if possible.
PURPOSE: Transplantation of hematopoietic stem cells from an unrelated donor (URD) is an option for many patients who do not have an HLA-identical sibling donor (MSD). Current criteria for the selection of URDs include consideration for HLA alleles determined by high resolution typing methods, with preference for allele-matched donors. However, the utility and outcome associated with transplants from URDs compared with those from MSDs remains undefined. PATIENTS AND METHODS: We examined clinical outcome after patients received bone marrow transplants (BMTs) from MSDs; HLA-A, -B, -C, and DRB1 allele-matched URDs (8/8); and HLA-mismatched URDs in a homogeneous population of patients with chronic myeloid leukemia (CML) in first chronic phase (CP1) where a strong allogeneic effect and hence a lower risk of relapse is anticipated. Transplantation outcomes were compared between 1,052 URD and 3,514 MSD BMT recipients with CML in CP1. RESULTS: Five-year overall survival and leukemia-free survival (LFS) after receipt of BMTs from 8/8 matched URDs were worse than those after receipt of BMTs from MSDs (5-year survival, 55% v 63%; RR, 1.35; 95% CI, 1.17 to 1.56; P < .001; LFS, 50% v 55%; RR, 1.21; 95% CI, 1.06 to 1.40; P = .006). Survival was progressively worse with greater degrees of mismatch. Similar and low risk of relapse were observed after receipt of transplant from either MSD or URD. CONCLUSION: In this homogeneous cohort of good risk patients with CML in CP1, 5-year overall survival and LFS after receipt of transplant from 8/8 allele-matched donors were modestly though significantly worse than those after receipt of transplant from MSDs. Additive adverse effects of multilocus mismatching are not well tolerated and should be avoided if possible.
Authors: E W Petersdorf; J A Hansen; P J Martin; A Woolfrey; M Malkki; T Gooley; B Storer; E Mickelson; A Smith; C Anasetti Journal: N Engl J Med Date: 2001-12-20 Impact factor: 91.245
Authors: P B McGlave; X O Shu; W Wen; C Anasetti; A Nademanee; R Champlin; J H Antin; N A Kernan; R King; D J Weisdorf Journal: Blood Date: 2000-04-01 Impact factor: 22.113
Authors: E W Petersdorf; C Kollman; C K Hurley; B Dupont; A Nademanee; A B Begovich; D Weisdorf; P McGlave Journal: Blood Date: 2001-11-15 Impact factor: 22.113
Authors: Daniel J Weisdorf; Claudio Anasetti; Joseph H Antin; Nancy A Kernan; Craig Kollman; David Snyder; Effie Petersdorf; Gene Nelson; Philip McGlave Journal: Blood Date: 2002-03-15 Impact factor: 22.113
Authors: Neal Flomenberg; Lee Ann Baxter-Lowe; Dennis Confer; Marcelo Fernandez-Vina; Alexandra Filipovich; Mary Horowitz; Carolyn Hurley; Craig Kollman; Claudio Anasetti; Harriet Noreen; Ann Begovich; William Hildebrand; Effie Petersdorf; Barbara Schmeckpeper; Michelle Setterholm; Elizabeth Trachtenberg; Thomas Williams; Edmond Yunis; Daniel Weisdorf Journal: Blood Date: 2004-06-10 Impact factor: 22.113
Authors: J-M Tiercy; J Passweg; A van Biezen; A Zander; N Kröger; A Gratwohl; B Chapuis; C Helg; L Brinch; J Cornelissen; M Oudshoorn; T Ruutu; L Volin; D Niederwieser; E Roosnek Journal: Bone Marrow Transplant Date: 2004-08 Impact factor: 5.483
Authors: K Scott Baker; James G Gurney; Kirsten K Ness; Ravi Bhatia; Stephen J Forman; Liton Francisco; Philip B McGlave; Leslie L Robison; David S Snyder; Daniel J Weisdorf; Smita Bhatia Journal: Blood Date: 2004-06-01 Impact factor: 22.113
Authors: Stephanie J Lee; John Klein; Michael Haagenson; Lee Ann Baxter-Lowe; Dennis L Confer; Mary Eapen; Marcelo Fernandez-Vina; Neal Flomenberg; Mary Horowitz; Carolyn K Hurley; Harriet Noreen; Machteld Oudshoorn; Effie Petersdorf; Michelle Setterholm; Stephen Spellman; Daniel Weisdorf; Thomas M Williams; Claudio Anasetti Journal: Blood Date: 2007-09-04 Impact factor: 22.113
Authors: Christian Gabriel; Stephanie Stabentheiner; Martin Danzer; Johannes Pröll Journal: Transfus Med Hemother Date: 2011-09-25 Impact factor: 3.747
Authors: Madan Jagasia; Mukta Arora; Mary E D Flowers; Nelson J Chao; Philip L McCarthy; Corey S Cutler; Alvaro Urbano-Ispizua; Steven Z Pavletic; Michael D Haagenson; Mei-Jie Zhang; Joseph H Antin; Brian J Bolwell; Christopher Bredeson; Jean-Yves Cahn; Mitchell Cairo; Robert Peter Gale; Vikas Gupta; Stephanie J Lee; Mark Litzow; Daniel J Weisdorf; Mary M Horowitz; Theresa Hahn Journal: Blood Date: 2011-10-18 Impact factor: 22.113
Authors: A A Hamidieh; M Ostadali Dehaghi; P Paragomi; S Navaei; A Jalali; G Ghazizadeh Eslami; M Behfar; A Ghavamzadeh Journal: Bone Marrow Transplant Date: 2015-01-26 Impact factor: 5.483
Authors: David Valcárcel; Jorge Sierra; Tao Wang; Fangyu Kan; Vikas Gupta; Gregory A Hale; David I Marks; Philip L McCarthy; Machteld Oudshoorn; Effie W Petersdorf; Olle Ringdén; Michelle Setterholm; Stephen R Spellman; Edmund K Waller; James L Gajewski; Susana R Marino; David Senitzer; Stephanie J Lee Journal: Biol Blood Marrow Transplant Date: 2010-07-30 Impact factor: 5.742
Authors: Marcelo A Fernandez-Viña; Tao Wang; Stephanie J Lee; Michael Haagenson; Mahmoud Aljurf; Medhat Askar; Minoo Battiwalla; Lee-Ann Baxter-Lowe; James Gajewski; Ann A Jakubowski; Susana Marino; Machteld Oudshoorn; Steven G E Marsh; Effie W Petersdorf; Kirk Schultz; E Victoria Turner; Edmund K Waller; Ann Woolfrey; John Umejiego; Stephen R Spellman; Michelle Setterholm Journal: Blood Date: 2014-01-09 Impact factor: 22.113
Authors: John M Goldman; Navneet S Majhail; John P Klein; Zhiwei Wang; Kathleen A Sobocinski; Mukta Arora; Mary M Horowitz; J Douglas Rizzo Journal: J Clin Oncol Date: 2010-03-08 Impact factor: 44.544
Authors: Marcelo A Fernández-Viña; John P Klein; Michael Haagenson; Stephen R Spellman; Claudio Anasetti; Harriet Noreen; Lee Ann Baxter-Lowe; Pedro Cano; Neal Flomenberg; Dennis L Confer; Mary M Horowitz; Machteld Oudshoorn; Effie W Petersdorf; Michelle Setterholm; Richard Champlin; Stephanie J Lee; Marcos de Lima Journal: Blood Date: 2013-04-17 Impact factor: 22.113